Coordinated Care May Address Emergency Department Use by Adults With Disabilities

Tuesday, January 08, 2013

Coordinated Care May Address Emergency Department Use by Adults With Disabilities

Working-age
adults with disabilities account for a disproportionately high amount of annual
emergency department visits, reports a comparison study from National Institutes of Health (NIH) researchers.

The NIH study analyzed pooled data from the Medical Expenditure
Panel Survey. Researchers found access to regular medical care, health
profile complexity, and disability status contributed to people with
disabilities' use of the emergency department.

Despite representing 17% of the working age US population, the study found
that adults with disabilities accounted for 39.2% of total emergency department
visits. Those with a severely limiting disability visited an urgent care
department more often than their peers and were more likely to visit the emergency
department more than 4 times per year.

Emergency visits also were associated with poor access to primary medical
care, which was more prevalent among adults with disabilities.

"We want to understand what takes people to the emergency department to
learn if their care could be better managed in other ways," said Elizabeth
Rasch, PhD, chief of the Epidemiology and Biostatistics Section in the NIH
Clinical Center's Rehabilitation Medicine Department. "While many of those
visits may be necessary, it is likely that some could be avoided through better
information sharing among all of the health care providers who see a particular
individual."

The authors make recommendations for providers and policymakers to offset
some of the need for emergency care by individuals with disabilities.
Prevention and chronic condition management programs tailored for the
functional limitations and service needs of people with disabilities may help
avoid a crisis situation that would call for an urgent care visit, the report
noted. The authors also endorsed wider adoption of coordinated care systems for
people with disabilities that provide case management, integration of
psychosocial care, and 24/7 access to medical assistance, among other services.

Free full text of the study is available online in Health Services Research.

Physical
therapists (PTs) are increasingly being asked to provide evaluation and
management of patients in the emergency department. As part of the emergency
department team, PTs have the opportunity to collaborate in the care of patients
with a wide range of acute and chronic problems coming from the
neuromusculoskeletal, cardiovascular/pulmonary and integumentary systems. PTs
in this setting also serve a critical role in screening for appropriateness of
care, consultation with other practitioners, and in the direct care of
patients. For more information about this expanding area of practice, visit
APTA's Physical Therapist Practice in the Emergency Department webpage, which includes a toolkit
designed to help PTs initiate the development of a PT practice in an
emergency department.